[#ftl]
<!DOCTYPE html>
<html>
<head>
<title>企业服务</title>
<script type="text/javascript">
</script>
</head>
<body> 
   <section class="content-header">
      <h3>
      	 基本信息
      	 <small>返回</small>
      </h3>
      <ol class="breadcrumb">
              <li><a href="#"><i class="fa fa-dashboard"></i> 基本信息</a></li>
              <li class="active">基础信息</li>
      </ol>
   </section>      
   <section class="invoice">
          <!-- title row -->
          <div class="row">
            <div class="col-xs-12">
              <div class="page-header">
                <button onclick="addA()" id="thisAdd" class="btn btn-primary" type="button">保存</button>
	            <button onclick="deleteA()" id="deleteDatas" class="btn btn-default" type="button">取消</button>	
              </div>
            </div><!-- /.col -->
          </div>
          <!-- info row -->
          <div class="row invoice-info">
            <div class="col-sm-5 invoice-col">
                  <label class="box-title col-lg-4"><h5>姓名：</h5></label>	                  
                  <div class="col-lg-7">
                    <input type="text" class="required form-control" id="name" name="name"/><br>
                  </div> 
                  <label class="box-title col-lg-4"><h5>手机号码：</h5></label>	                  
                  <div class="col-lg-7">
                      <input type="text" class="required form-control" id="name" name="name"/><br>
                  </div>
				  <label class="box-title col-lg-4"><h5>QQ：</h5></label>	                  
                  <div class="col-lg-7">
                      <input type="text" class="form-control" id="name" name="name"/><br>
                  </div> 
                  <label class="box-title col-lg-4"><h5>客户分类：</h5></label>	                  
                  <div class="col-lg-7">
                      <select name="status" class="form-control">
					    <option value='0'>分类1</option>
			            <option value='1'>分类2</option>
			          </select><br>
                  </div> 
                  <label class="box-title col-lg-4"><h5>当前负责人：</h5></label>	                  
                  <div class="col-lg-7">
                      <input type="text" class="form-control" id="name" name="name"/>
                  </div>   
            </div>
            <div class="col-sm-5 invoice-col">
                  <label class="box-title col-lg-4"><h5>性别：</h5></label>	                  
                  <div class="col-lg-7">
                    <input type="text" class="required form-control" id="name" name="name"/><br>
                  </div>   
                  <label class="box-title col-lg-4"><h5>邮箱：</h5></label>	                  
                  <div class="col-lg-7">
                      <input type="text" class="required form-control" id="name" name="name"/><br>
                  </div>
                  <label class="box-title col-lg-4"><h5>微信：</h5></label>	                  
                  <div class="col-lg-7">
                      <input type="text" class="required form-control" id="name" name="name"/><br>
                  </div>
                  <label class="box-title col-lg-4"><h5>出生日期：</h5></label>	                  
                  <div class="col-lg-7">
                      <input type="text" class="required form-control" id="name" name="name"/><br>
                  </div>    
            </div>
            <div class="col-sm-2 invoice-col">
              <div class="col-lg-12">
                  <img src="${base}/lte/img/user2-160x160.jpg" class="img-responsive" style="width: 100px; height: 100px;">	                  
			  </div>    
           </div>
          </div>
          <!-- title row -->
		  <div class="row">
            <div class="col-xs-12">
              <div class="page-header">
                <h4>信息来源</h4>
              </div>              
            </div><!-- /.col -->
          </div>

          <div class="row invoice-info">
            <div class="col-sm-5 invoice-col">
                  <label class="box-title col-lg-4"><h5>获取渠道：</h5></label>	                  
                  <div class="col-lg-7">
                    <select name="status" class="form-control">
					    <option value='0'>分类1</option>
			            <option value='1'>分类2</option>
			        </select><br>
                  </div>   
                  <label class="box-title col-lg-4"><h5>收集人：</h5></label>	                  
                  <div class="col-lg-5">
                      <input type="text" class="required form-control" id="name" name="name"/>
                  </div>
                  <div class="col-lg-2">
                      <button type="button"  class="btn btn-default"  onclick="conditionQuery();">选择</button><br>
                  </div>  
            </div>
            <div class="col-sm-6 invoice-col">
                  <label class="box-title col-lg-3"><h5>客户如何<br>知道我们：</h5></label>	                  
                  <div class="col-lg-6">
                    <select name="status" class="form-control">
					    <option value='0'>分类1</option>
			            <option value='1'>分类2</option>
			        </select><br>
                  </div>   
            </div>
          </div><!-- /.row -->
          <div class="row">
            <div class="col-xs-12">
              <div class="page-header">
                <h4>身份信息</h4>
              </div>              
            </div><!-- /.col -->
          </div>

          <div class="row invoice-info">
            <div class="col-sm-4 invoice-col">
                  <label class="box-title col-lg-5"><h5>证件类型：</h5></label>	                  
                  <div class="col-lg-7">
                    <select name="status" class="form-control">
					    <option value='0'>分类1</option>
			            <option value='1'>分类2</option>
			        </select>
                  </div>
             </div>      
             <div class="col-sm-4 invoice-col">
                  <label class="box-title col-lg-5"><h5>证件号码：</h5></label>	                  
                  <div class="col-lg-7">
                    <input type="text" class="required form-control" id="name" name="name"/><br>
                  </div> 
            </div>
            <div class="col-sm-4 invoice-col">
                  <label class="box-title col-lg-4"><h5>职业：</h5></label>	                  
                  <div class="col-lg-7">
                    <input type="text" class="required form-control" id="name" name="name"/><br>
                  </div>   
            </div>
          </div><!-- /.row -->
          <div class="row invoice-info">    
             <div class="col-sm-6 invoice-col">
                  <label class="box-title col-lg-3"><h5>联系地址：</h5></label>	                  
                  <div class="col-lg-8">
                      <input type="text" class="required form-control" id="name" name="name"/>
                  </div>  
            </div>
          </div><!-- /.row -->
        </section> 
</body>
</html>
